scholarly journals Changing incidence of invasive pneumococcal disease in infants less than 90 days of age before and after introduction of the 13-valent Pneumococcal Conjugate Vaccine in Blantyre, Malawi: a 14-year hospital based surveillance study

Author(s):  
Marianne Koenraads ◽  
Todd D. Swarthout ◽  
Naor Bar-Zeev ◽  
Comfort Brown ◽  
Jacquline Msefula ◽  
...  

AbstractBackgroundInvasive pneumococcal disease (IPD) in young infants is uncommon but associated with high morbidity and mortality. Accurate data on the burden of IPD in young infants in low-income countries are lacking. We examined the burden of IPD in infants aged <90 days in Blantyre, Malawi over a 14 year period and evaluated the impact of the 12 November 2011 introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) on vaccine-serotype IPD (VT-IPD) in this population.MethodsWe conducted laboratory-based prospective IPD surveillance in infants aged <90 days admitted to Queen Elizabeth Central Hospital (QECH) in Blantyre between 2005 and 2018, including 7 years pre- and 7 years post-PCV13 introduction. IPD was defined as Streptococcus pneumoniae identified by culture from blood or cerebrospinal fluid. Serotypes were determined by multiplex PCR and latex agglutination testing.ResultsWe identified 130 cases of culture-confirmed IPD in infants <90 days old between 2005-2018. Total IPD incidence was declining prior to PCV13 introduction. The mean incidence of IPD was significantly lower in the post-PCV era. Serotypes 5 (27.8%) and 1(15.6%), were most prevalent. Even after PCV13 introduction, VT-IPD remained dominant with serotype 5 accounting for 17.4% and serotype 1 for 13% of cases in young infants.ConclusionVaccine serotypes were the main cause of IPD in neonates and young infants, both before and after PCV13 introduction. Further strategies need to be considered to protect this vulnerable population, including maternal or neonatal immunization and implementation of an alternative PCV schedule with a booster dose.SummaryThe incidence of invasive pneumococcal disease in infants in Blantyre, Malawi has declined over the past decade and more significantly after introduction of the pneumococcal conjugate vaccine. Vaccine serotypes have remained the main cause of disease in this population.

2012 ◽  
Vol 31 (9) ◽  
pp. e169-e175 ◽  
Author(s):  
Jenine Leal ◽  
Otto G. Vanderkooi ◽  
Deirdre L. Church ◽  
Judy MacDonald ◽  
Gregory J. Tyrrell ◽  
...  

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262225
Author(s):  
Sweta M. Patel ◽  
Yazdani B. Shaik-Dasthagirisaheb ◽  
Morgan Congdon ◽  
Rebecca R. Young ◽  
Mohamed Z. Patel ◽  
...  

Pneumococcal conjugate vaccines reduce the burden of invasive pneumococcal disease, but the sustained effect of these vaccines can be diminished by an increase in disease caused by non-vaccine serotypes. To describe pneumococcal serotype epidemiology in Botswana following introduction of 13-valent pneumococcal conjugate vaccine (PCV-13) in July 2012, we performed molecular serotyping of 268 pneumococcal strains isolated from 221 children between 2012 and 2017. The median (interquartile range) age of the children included in this analysis was 6 (3,12) months. Fifty-nine percent of the children had received at least one dose of PCV-13 and 35% were fully vaccinated with PCV-13. While colonization by vaccine serotypes steadily declined following PCV-13 introduction, 25% of strains isolated more than 3 years after vaccine introduction were PCV-13 serotypes. We also observed an increase in colonization by non-vaccine serotypes 21 and 23B, which have been associated with invasive pneumococcal disease and antibiotic resistance in other settings.


Author(s):  
Roger Baxter ◽  
Laurie Aukes ◽  
Stephen I Pelton ◽  
Arnold Yee ◽  
Nicola P Klein ◽  
...  

Abstract Background In 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced 7-valent PCV (PCV7) for protection against invasive pneumococcal disease (IPD). This study used laboratory surveillance data to examine the effect of PCV13 on IPD before and after PCV13 introduction among children aged 6 weeks to &lt;6 years and those aged ≥6 weeks. Methods Observational laboratory-based IPD surveillance data were compared for the periods May 2010–April 2018 and May 2008–April 2010 (the PCV7 period) using a database of Kaiser Permanente Northern California (KPNC) members with laboratory-confirmed IPD. Results Among children aged 6 weeks to 6 years, overall IPD incidence decreased from 11.57 per 100 000 during the PCV7 period to 4.09 per 100 000 after PCV13 introduction; PCV13-type IPD incidence decreased from 5.12 to 0.84 per 100 000. Non-PCV13−serotype IPD did not change significantly in this age group (PCV7 period, 1.71 per 100 000 and after PCV13, 2.52 per 100 000). Of cases occurring in this group, bacteremia was the most common clinical diagnosis. Across all ages, IPD decreased from 9.49 to 6.23 per 100 000 and PCV13-type IPD decreased from 4.67 to 1.89 per 100 000, changes being mostly due to decreases in serotypes 19A and 7F. IPD caused by non-PCV13 serotypes did not change (3.34 and 3.35 per 100 000). Overall, pneumococci isolated after PCV13 introduction had increased susceptibility to penicillin, cefotaxime, and ceftriaxone. This prospective, laboratory-based surveillance study in Kaiser Permanente Northern California members examined annual IPD incidence before and after PCV13 introduction. In children aged 6 weeks to &lt;6 years, IPD caused by PCV13 serotypes decreased significantly (84%) during the surveillance period. Conclusions IPD incidence decreased further in every age group after PCV13 introduction, suggesting both direct vaccination effects in the infant population and indirect effects in adults. Clinical Trials Registration NCT01128439.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247862
Author(s):  
Jana Kozakova ◽  
Pavla Krizova ◽  
Marek Maly

Introduction The aim of this study is to analyse the impact of vaccination of infants with pneumococcal conjugate vaccine (PCV) on the incidence of invasive pneumococcal disease (IPD) in children under 5 years of age in the Czech Republic. Material and methods The present study includes all IPD cases reported in children aged 0–4 years within the surveillance program in 2007–2017. The impact of PCV is analysed for five categories of IPD: cases caused by all serotypes, cases caused by PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, and 23F), cases caused by three additional PCV10 serotypes (1, 5, and 7F), cases caused by three additional PCV13 serotypes (3, 6A, and 19A), and cases caused by non-PCV serotypes. To assess the impact of PCV, the study period was divided into the pre-vaccination period 2007–2008 and post-vaccination period 2009–2017, which was divided into three three-year parts: 2009–2011, 2012–2014, and 2015–2017. Analysis of differences between periods was based on the Poisson regression model where the population numbers were handled as an offset. Results The annual incidence of IPD in children under 5 years of age caused by all serotypes has had a downward trend since 2007: it dropped from 8.52/100 000 in 2007 to 2.67/100 000 in 2017, with slight increases in 2010 and 2013. All three post-vaccination periods show significantly lower (p<0.001) incidences in comparison to the pre-vaccination period, but they do not statistically significantly differ from each other. Conclusions IPD surveillance data in the Czech Republic show that after the introduction of PCV vaccination of infants, there has been a significant decrease in the IPD incidence of children under 5 years of age. Continued IPD surveillance is essential to monitor for possible post-vaccination serotype replacement.


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